小儿尿路感染100例病因分析

本文报告小儿尿路感染１００例。据有无诱发因将其分为单纯型和复杂型两组。分别对致病菌，及其对临床常用抗生素的敏感性等问题进行了分析。单纯型致病菌以大肠杆菌为主，占７３．９％；复杂型，仅占４５．０％；二者有非常显著统计学差异。致病菌对抗生毒敏感性两组间也有显著不同。同时还指出原发性肾病伴尿路感染的重要性。     

UF-500i尿沉渣分析仪在尿路感染早期诊断中的筛查

目的利用UF-500i全自动尿沉渣分析仪（简称UF-500i）对尿沉渣中的细菌进行定量分析,从而对尿路感染进行早期诊断。方法对345份新鲜中段尿标本做细菌培养菌落计数和UF-500i尿沉渣分析。结果 UF-500i细菌计量大于4000/μl时,UF-500i尿沉渣分析仪细菌值与尿细菌培养结果无显著性差别（χ2=2.95,P〉0.05）,检测敏感性为80.3%;而特异性为90.3%。结论当UF-500i检测出细菌值大于4000/μl能够作为临床诊断尿路感染的早期依据之一,可在尿路感染早期诊断中发挥重要作用。     

UF-1000i全自动尿液分析仪诊断及鉴别不同细菌致尿路感染的临床应用

目的：探讨UF-1000i全自动尿液分析仪对于不同细菌所致尿路感染的诊断鉴别价值。方法：选取尿液标本300份,采用UF-1000i全自动尿液分析仪进行定量分析以及尿细菌培养,比较分析UF-1000i筛查结果与尿培养结果。结果：细菌数量最佳临界值为595．3／μL,白细胞计数的最佳临界值为55．4／μL;UF-1000i全自动尿液分析仪对于尿路感染的诊断特异度为97．55％,敏感度为86．4％。结论：UF-1000i全自动尿液分析仪对于细菌尿路感染具有较高的诊断准确率,操作简便、快速,结合其他实验室指标以及尿液培养可提高诊断鉴别准确率,值得推广应用。     

Management of urinary tract infections

Urinary tract infections (UTIs) are commonly encountered in medical practice and range from asymptomatic bacteruria to acute pyelonephritis. Enterobacteriaceae with E. coli being the most prevalent, are responsible for most commonly acquired uncomplicated UTIs and usually respond promptly to oral antibiotics. In contradistinction, more resistant pathogens cause nosocomially acquired infections which often require parenteral antibiotic therapy. Patients with acute bacterial prostatitis, usually caused by Enterobacteriaceae present with a tender prostate gland and respond promptly to antibiotic therapy. Chronic bacterial prostatitis on the other hand, is a subacute infection characterized by recurrent episodes of bacterial UTI where the patient presents with vague symptoms of pelvic pain and voiding problems. Treatment is protracted and may be frustrating. Nonbacterial prostatitis and chronic pelvic pain syndrome produce symptoms similar to those of chronic bacterial prostatitis. Treatment is not well defined due to their uncertain etiologies. Most episodes of catheter associated bacteruria are asymptomatic, where less than 5% will be complicated by bacteremia. The use of systemic antibiotics for treatment or prevention of bacteruria is not recommended, particularly in the geriatric age group, since it helps select for resistant organisms. Prevention thus remains the best option to control it. Few patients without catheters who have asymptomatic bacteruria develop serious complications and therefore routine antimicrobial therapy is not justified with only two exceptions : before urologic surgery and during pregnancy.     

Antibiotic resistance pattern and empirical therapy for urinary tract infections in children

OBJECTIVES: To study the type of bacterial pathogen causing urinary tract infection in children at Aseer Central Hospital, southwestern Saudi Arabia, and their antimicrobial resistance patterns. METHODS: A retrospective study of all the urine cultures carried out on children in the period from January 2003 to December 2006, for a total of 4 years were reviewed at the bacteriology laboratory, Aseer Central Hospital, southwestern region of Saudi Arabia. Their antimicrobial resistances as well as sensitivities were also analyzed. RESULTS: A total of 464 urine cultures were identified. Escherichia coli constitutes the most common pathogen isolated (37.3%), followed by Klebsiella (16.4%) and Pseudomonas species (15.7%). In general, there was a significant increase in the resistance rates of different bacterial pathogens to different antibiotics. CONCLUSION: In spite of an increase in the resistance rates of bacterial pathogens causing UTI, ceftriaxone, imipenem, and to some extent Azactam are appropriate for initial empirical intravenous therapy in UTI. In patients with uncomplicated UTI not requiring hospitalization, Nalidixic acid, and Nitrofurantoin can be used as oral treatment.